Exploring Gender Identity

The Gender Sexual Connection

by Sequoia Elisabeth on June 21, 2011

Sex: The physical sexual organs, what is between the legs. This can change due to sexual reassignment surgery; includes male, female and intersex.

Gender: Separate and different from an individual‘s physical sex or sexual orientation (hetero, homo, bi, or asexual), it is an individual‘s perception of the inner self as man, woman or some combination of both, transgender.

Operating from the above definitions we now know that gender and sex are very different and yet from experience we also know that they are intimately connected. How do we work out this connection? Is it meaningful?

Sexual Orientation is the trait we give the most attention because it involves others. Who are you attracted to? Why? Does gender really have anything to do with this attraction? How important is appearance? What about body parts? Some people are turned on by toes and if this is the case does it matter what is between their legs? What if ears are a turn on, the same question applies. You are probably saying that what it leads to is very important and this is where the genitalia come in. I agree completely.

In the transgender world we offer a contradiction to this process. Our parts do not match the majority of the human race. So do we have GRS to conform or is it more practical than that, simply to enjoy sex in a manner which supports our mental functions? Many transgender women have surgery just because they cannot bear having male genitalia. It is like having a large growth on your body which causes you distress. It could just as well be a tumorous growth! In this case having surgery is medically necessary, as much as any person with a tumorous growth. When the result is a happy well adjusted individual post op it is hard to argue against GRS/SRS.

“The reported 68%-86% overall success rates for sex reassignment surgery must be viewed cautiously; the lack of long-term follow-up studies makes these statistics misleading. There is evidence suggesting that some gender dysphoric patients benefit primarily from sex reassignment surgery. Most such patients, however, are secondary transsexuals who can benefit from various modes of psychotherapy. Sex reassignment surgery should only be considered as the last resort for a highly select group of diagnosed gender dysphoric patients. As physicians learn new ways to diagnose and treat transsexualism, either sex reassignment surgery will be abandoned as a routine treatment modality or new predictive variables for choosing suitable patients for sex reassignment surgery will be established.” (Lothstein, Am J Psychiatry 1982; 139:417-426) The above quote is a bit out dated now and this author finds it interesting that its prediction is far from correct. SRS has grown in popularity as surgical techniques have been perfected. It is now the best treatment known for severe gender dysphoria. The question remains, what if the dysphoria is mild? What constitutes mild? This is between the patient and their counselor or therapist.

The final point or question I wish to raise is, does sexual orientation figure into ones decision to have surgery or not? From the clinical perspective, the answer would be no. Dysphoria is separate from sexual behavior and needs to be treated regardless of sexual orientation. The practical side of the issue is a personal one. Transsexuals often start off in same sex relationships and to have surgery would destroy the identities associated with the relationship, so unless both individuals are flexible the relationship ends. This is even the case in heterosexual relationships since it would be homosexual after surgery. Those relationships that do survive often forgo sex altogether.

One of the most difficult aspects of the transgender journey is relationships and the changes they must go through along the way. The losses are often heart breaking, but this is not necessarily a bad thing. It can lead to more loving and authentic relationships! The road has many potholes, so it is best to proceed with caution.